A comprehensive and concise assessment of suicide risk.

Because suicide is one of the few fatal consequences of psychiatric illness and is a source of extraordinary stress for loved ones and the clinician, accurate assessment of suicidal risk is an essential aspect of the mental health profession. Innumerable individual differences, along with the low base rate of suicide, make assessment a challenging task in clinical practice that is both delicate and time consuming. In this article, the authors recommend examining and incorporating each patient's personal characteristics, dispositional factors, situational factors, and current presentation of symptoms into a unique individual picture of suicidal risk. This portrait of potential for suicidal behavior can, in turn, be used to evaluate risk and design a course of action. This thorough yet concise approach will likely reduce omissions in assessment, and hopefully lead to fewer false negatives and fewer deaths of suicidal patients.

Legal issues of professional negligence in suicide cases.

Suicide is the eleventh leading cause of death, accounting for almost 30,000 deaths each year in the United States. The loss of a patient to suicide is the most feared outcome among mental health professionals, while the fear of litigation and liability after such suicide may be a close second. This article will familiarize mental health professionals with the legal issues of professional negligence in suicide cases. We begin with an introduction to malpractice liability for suicidal patients, followed by an explanation of the essential elements of professional negligence and relevant legal terminology. We then discuss general theories of liability involving suicide, and provide illustrative legal case examples. We conclude with a discussion of risk management procedures that can substantially reduce one's exposure to malpractice liability.

Malpractice arising from negligent psychotherapy: ethical, legal, and clinical implications of Osheroff v. Chestnut Lodge.

Traditionally, there have been few legal actions brought against psychotherapists that allege negligent psychotherapy and negligent treatment of psychiatric disorders. However, in the case of Osheroff v. Chestnut Lodge, a patient-physician (Dr. Osheroff) sued Chestnut Lodge, a private psychiatric facility, for negligence based on the staff's decision to apply a psychodynamic model of treatment (through psychotherapy) and not a biological model. The case sparked a heated debate between adherents of the psychodynamic model and those of the biological model. This article explores the implications of the Osheroff litigation for mental health professionals. It is proposed that an interactive informed consent process be used to protect psychotherapists against Osheroff-type litigation.